چاپ صفحه |  صفحه نخست سامانه |  چکیده مقاله |  نویسندگان |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| COPD: Chronic Obstructive Pulmonary Disease; ETCO2: End Tidal CO2; ETT: Endo Tracheal Tube; PaCO2: Arterial Pressure of CO2; AHA: American Heart Association; ROSC: Return of Spontaneous Circulation; CPR: Cardiopulmonary Resuscitation “Laudation to the God of majesty and glory! Obedience to him is a cause of approach and gratitude in increase of benefits. Every inhalation of the breath prolongs life and every expiration of it gladdens our nature; wherefore every breath confers two benefits and for every breath gratitude is due.”1 Saadi Shirazi, the prominent Persian-Iranian poet living in the 12th- 13th century whose aphorism “Bani Adam” or the Children of Adam ornaments the entrance of the United Nations, in the introduction section of the Golestan, has elaborately described the importance of the two sections of respiration. Capnography is one of the non-invasive methods used for the measurement of End-tidal CO2 values (ETCO2). Values for ETCO2 alter based on the CO2 concentrations in each respiratory cycle [1]. Ancient Greeks believed that human body is equipped with a kind of “combustion engine” producing smoke, i.e. breathing; hence, the termcapnography is derived from the Greek word “Capnos” meaning smoke [1,2]. The mechanism of respiration includes two stages of oxygenation and ventilation with are considered as the natural physiological functions of the body that should be taken into consideration in the evaluation of the intubated patients and non-intubated patients with normal respiration. Oxygenation can normally be monitored using pulse oxymetry whereas capnography can provide more accurate information on each respiration cycle regarding ventilation, perfusion, cardiac output, pulmonary blood flow and metabolic status [1]. Carbon dioxide is produced a human body following glucose metabolism which is later delivered to pulmonary blood circulation transferred to the exhaled air through the alveoli. In expiration phase, primarily the air in the upper airways is exhaled; the process is followed by the expiration of the air content of the lower airways. Capnogram demonstrates CO2 content of the expired air throughout the whole expiration phase. Most technologies used in the capnography are based on infrared wave; as CO2 absorbs infrared waves in the specific wavelength of 4.26 nm. Therefore, the amount of the absorbed waves is in close relation with the CO2 content of the expired air [1-3]. In patients with normal pulmonary function, apart from their age, the difference between ETCO2 and arterial carbon dioxide pressure (PaCO2) is a constant figure (2-5 mmHg) [2,3]. This difference originates from the dead alveolar spaces in a normal lung which is ineffective in the ventilation process. Capnography device demonstrates ETCO2 Values and its related curves [2]. A normal capnogram has been illustrated in figure 1 in which the blue line is indicative of PaCO2. The distance between the blue line and section III (C-D distance) is the normal befriends between ETCO2 and PaCO2. In this figure, A is the start point of inspiration; D is the end point of expiration from which the new inspiration cycle starts. The height of the curve is related to ETCO2 whereas its width is related to expiration time [1,3]. The changes in the shape of the curve could be suggestive of the underlying diseases and the alterations in the ETCO2 values could be utilized for the assessment of the severity of the diseases and response to treatment [1]. An emergency medicine physician should be aware of abnormal curves caused by technical problems of the device and also the contributing physiological and pathological conditions in order to monitor the patients more accurately and to increase his or her diagnostic abilities |
| نویسنده | نفر چندم مقاله |
|---|---|
| حسن سلیمانپور | اول |
| چنگیز قلی پور | دوم |
| صمد اسلام جمال گلزاری | سوم |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| E-Capno in ED.pdf | 1398/09/04 | 1132359 | دانلود |
